Feeding Management and Palate Repair Timing in Infants with Cleft Palate with and without Pierre Robin Sequence: A...

Area of Science:

• Pediatric surgery
• Craniofacial anomalies
• Developmental pediatrics

Background:

• Pierre Robin sequence (PRS) is a congenital condition characterized by mandibular hypoplasia, glossoptosis, and cleft palate.
• Infants with PRS often experience significant feeding difficulties impacting growth and development.
• Optimal timing for palate repair in infants with cleft palate, especially those with PRS, is critical for speech and facial development.

Purpose of the Study:

• To compare feeding management practices in infants with cleft palate with and without PRS.
• To identify feeding difficulties and interventions that predict delayed palate repair.
• To inform clinical strategies for optimizing care in infants with PRS and cleft palate.

Main Methods:

• Retrospective cross-sectional study involving 414 infants from 17 cleft palate teams.
• Data collected through parent interviews and electronic health records.
• Outcomes included feeding difficulties, growth, interventions (therapy, fortification, enteral feeding), and age at primary palate repair.

Main Results:

• Infants with PRS showed higher rates of feeding difficulties (81% vs. 61%) and poor growth (29% vs. 15%) than infants with cleft palate only.
• PRS infants received feeding interventions more frequently.
• Primary palate repair was significantly delayed in infants with PRS (mean 13.55 months) compared to cleft palate only (mean 12.05 months).
• Predictors of delayed repair included PRS diagnosis, Hispanic ethnicity, and history of poor growth.

Conclusions:

• Infants with PRS require intensive feeding support due to higher prevalence of feeding difficulties and poor growth.
• Multimodal feeding interventions should be implemented early for infants with PRS to support growth.
• Timely palate repair in infants with PRS may be facilitated by proactive and comprehensive feeding management.